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目的探讨在急诊重症监护室(EICU)经皮扩张气管置管术(PDT)的应用及管理。方法将40例需气管切开的危重患者随机分为 PDT 组(20例)和传统气管切开组(20例)。PDT 组行经皮气管置管术,传统气管切开组行气管切开插管。观察2组的操作时间、切口大小、伤口愈合时间及并发症的发生率。结果 PDT 组手术操作时间、切口长度、出血量和气管导管拔除后切口愈合时间明显低于传统气管切开组(P<0.001)。PDT 组有1例皮下气肿,传统气管切开组有1例皮下气肿、1例切口感染,2组并发症发生率无统计学意义(P>0.05)。结论 PDT 创伤小,手术有效、快速、安全,在 EICU 具有极大的推广应用价值。
Objective To explore the application and management of percutaneous dilational endotracheal tube placement (PDT) in emergency intensive care unit (EICU). Methods Forty critically ill patients undergoing tracheotomy were randomly divided into PDT group (n = 20) and tracheotomy group (n = 20). PDT group tracheotomy tube tracheotomy group tracheotomy tube. The operation time, the incision size, the wound healing time and the complication rate of the two groups were observed. Results The operation time, incision length, bleeding volume and wound healing time after PDT were significantly lower in PDT group than those in tracheotomy group (P <0.001). There was 1 case of subcutaneous emphysema in PDT group, 1 case of subcutaneous emphysema and 1 case of incision infection in conventional tracheotomy group. There was no significant difference in the complication rates between the two groups (P> 0.05). Conclusion PDT trauma, surgery is effective, fast and safe, has great promotion and application value in EICU.